Rabies in humans
What is rabies?
Rabies is a virus that can affect both humans and other mammals. The virus gets into the body from a bite or scratch and attacks the central nervous system. With exposures to rabid bats, the break in the skin may be so minor that it is often not recognized or remembered. Proper treatment obtained as soon as possible after exposure to a rabid animal can prevent rabies, but once symptoms begin rabies is almost always fatal.
What is my risk of getting rabies from another person?
The only documented cases of rabies acquired from another person occurred when organs of persons who died of rabies were transplanted into other persons.
No other cases have been documented from situations other than solid organ or corneal transplants. Even though there has been no documentation that the virus could be passed by situations other than transplants, the possibility still exists.
Human saliva is not thought to be very infectious.
Some researchers theorize that the rabies virus in human saliva glands may be at too low a level for transmission to occur. In spite of the seemingly low risk, rabies exposures to saliva should be taken seriously due to the deadly nature of this disease.
What types of contact with people who might have rabies could be cause for getting rabies treatment?
Who does not require rabies post exposure treatment?
- Bites, with penetration of skin by the teeth
- Exposure to the person's saliva, spinal fluid, internal organs or tissues, urine, tears, eye tissue which resulted in these having direct contact with mucous membranes (mouth, nose, eye tissues), or with broken skin.
- Scalpel nicks or needle sticks if the treatment was in contact with spinal fluid, nervous tissue, eye tissue, or internal organs.
When are people with rabies communicable to others?
- People who had contact with infectious material from another person, but had no breaks or sores on their skin where they were exposed, do not need rabies treatment.
- People who had any contact with blood, stool, or unspun urine do not need rabies treatment.
The period of time that a person with rabies could be communicable is not yet defined precisely. However studies done with dogs suggest that the week before the onset of illness symptoms should be considered as the beginning of the communicable period.
- Srinivasan A, Burton EC, Kuehnert MJ, et. al. Transmission of rabies virus from an organ donor to four transplant recipients. NEJM 2005;352:1103-1111.
- CDC. Rabies prevention--United States, 1991: Recommendations of the Immunization Practices Advisory Committee (ACIP) MMWR 1991;40:1-19.
- Helmick CG, Tauxe, RV, Vernon AA. Is there a risk to contacts of patients with rabies? Rev Infect Dis 1987;9:511-8.